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Apr 04, 2013

Research Sheds Light on How Long Anticoagulants Should Be Taken After Stenting

Patients taking clopidogrel (Plavix) for a long period don’t see any health benefits and actually have a higher risk of bleeding.

Stenting is one of the best ways to keep arteries open following a coronary angioplasty—a procedure used to open clogged arteries in the heart. Stents help prop the arteries open following their procedure, which helps promote normal blood flow and reduce risk for heart attack.

Stents are generally safe, although patients need to take blood-thinning medications to reduce the risk of a blood clot developing in the stent and blocking blood flow. Patients often take a clot-fighting drug, clopidogrel (Plavix), for a year or more after their procedure, and take aspirin indefinitely to reduce risk of blood clots. But according to a recent study presented at the American College of Cardiology’s 62nd Annual Scientific Session, extended use of clopidogrel may do more harm than good, despite its clot-busting qualities.

This study, referred to as the DES-LATE (Duration of Clopidogrel Therapy After Drug-Eluting Stent) Trial, followed more than 5,000 Korean patients receiving drug-eluting stents for over three years to see how different use of blood thinners affected outcomes. All patients started out taking clopidogrel plus aspirin following their procedures, but some stopped taking clopidogrel after a year while others continued for three or more years. Unfortunately, patients taking clopidogrel for the extended period didn’t see any health benefits and actually had increased risk of bleeding compared to those who stopped taking clopidogrel after a year.

These findings are important because although we know that clopidogrel can help reduce risk of complications after stenting, it’s unclear exactly how long patients should continue taking this therapy after their procedure. It seems logical that longer clopidogrel use would help protect patients better from clots after stenting, but this study proved otherwise. With additional research, experts hope to determine the exact window for clopidogrel use that will improve outcomes and minimize risk of complications.

Questions for You to Consider

  • What is clopidogrel?
  • Clopidogrel (Plavix) is an antiplatelet drug that helps fight the formation of blood clots. Clopidogrel is typically taken by patients with certain heart conditions or patients undergoing heart procedures to reduce risk of stroke and heart attack.

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